Promoting sustained access to cognitive behavioral therapy for insomnia in Australia: a system-level implementation
Alexander Sweetman1, R Doug McEvoy1, Michael S Frommer2
1Adelaide Institute for Sleep Health, and Flinders Health and Medical Research Institute: Sleep Health, Flinders University, Adelaide, South Australia, Australia.
Summary
Improving access to cognitive behavioral therapy for insomnia (CBTi) in Australia required a system-level approach. This program identified barriers and implemented strategies to increase CBTi availability for those with insomnia.
Area of Science:
- Implementation Science
- Health Systems Research
- Sleep Medicine
Background:
- Insomnia is a common and impactful sleep disorder.
- Cognitive behavioral therapy for insomnia (CBTi) is the primary treatment, yet access is limited.
- A system-level implementation program was developed to address CBTi access in Australia.
Purpose of the Study:
- To describe a system-level implementation program aimed at enhancing access to CBTi in Australia.
- To provide insights for CBTi implementation in other global regions.
- To identify and address barriers to CBTi access.
Main Methods:
- A multi-phase program (2019-2023) utilized a system-level approach, knowledge brokerage, and co-design.
- Qualitative, quantitative, and implementation science methodologies were employed.
- Barriers and facilitators to CBTi access were systematically mapped and analyzed.
Main Results:
- Barriers to CBTi access were identified from patient, clinician, and health system perspectives.
- A stakeholder committee co-designed change goals and strategies.
- Initiatives included enhancing clinician education, promoting self-guided interventions, and advocating for funding.
Conclusions:
- The implementation program achieved notable progress in improving CBTi access in Australia.
- Sustained, long-term system-level change necessitates ongoing stakeholder commitment and resources.
- The program's framework can guide future CBTi implementation efforts internationally.
Keywords:
CBTidifficulties initiating and maintaining sleepimplementation scienceinsomniaknowledge translationnonpharmacologicalMore Related Videos
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